Rely on Experts: SLUCare Breast Radiology

When Interpreting Mammograms, Specialization Matters

You get a mammogram. A few weeks later, a letter arrives in the mail saying you have
dense breasts and could be at a higher risk for breast cancer. It sounds terrifying, but there's no need to panic, says SLUCare breast radiologist
Dr. Debbie Bennett. "About half of all women have dense breasts. It's not a disease, and it's not abnormal.
It's how half the population is normally made."

Until recently, most women had never heard of dense breasts. The issue has gained
attention, however, as dozens of states, including Missouri, have passed laws that
require mammography providers to notify women who have dense breast tissue. Dense
breasts have a higher percentage of glandular tissue than fatty tissue, and the composition
is impossible to diagnose visually or by touch, Bennett says. The only accurate assessment
is mammogram.

Studies show that dense tissues increase the risk of a woman getting breast cancer
over her lifetime "by about 1.2 times, or as much as two times for really dense breasts,
which only 2 percent of women have," Bennett says. Glandular tissue also makes it
more difficult for a radiologist to detect tumors in a regular mammogram. The statistics
are scary, but Bennett cautions that most women have no need for increased alarm.
"I think it's useful to know if you have dense breasts, but I don't think it's useful
for most people to worry about it."

Despite recent awareness of breast density, screening advice remains largely unchanged,
Bennett says. Women in their 20s and 30s should have a clinical breast exam every
three years, and every year by age 40. After age 40, women should also have a mammogram
every year for as long as they are in good health. Screening may start earlier for
women who are at high risk for breast cancer, including those with strong family history
of the disease, who have a known BRCA1 or BRCA2 gene mutation, and those who've had several benign breast biopsies."

The upside of so much focus being placed on dense breasts, Bennett says, is increased
discussions between patients and doctors about tailored screenings, such as 3-D mammograms.
"They find more cancers than regular mammograms," she says. "There's great benefit
for women with dense breasts, because those are the women in whom it's harder to find
breast cancer on regular mammograms."

A breast specialist ... is much more likely to notice subtle changes that could be
the first signs of breast cancer.”

Dr. Debbie Bennett, SLUCare Breast Radiologist

Understanding the common nature of dense breasts can allow women to breathe a little
easier when their post-mammogram letter shows up, Bennett says. They may find further
solace, she says, in having their mammograms read by a breast specialist, who is "much
more likely to notice subtle changes that could be the first signs of breast cancer,"
she says. "They also are really passionate about breast cancer, so if you have to
come back in for more pictures or a biopsy, you get to talk to someone who really
cares about your well-being and your breast health."